CRE Note: Rest assured, the release of the TPSAC report on menthol represents the launching point of a contentious debate and a prolonged regulatory review. Well financed anti-menthol groups will flood the regulators with a series of studies aimed at moving the FDA to regulate menthol. CRE will be responding to these studies to ensure that the resultant regulatory docket is not one-sided. CRE can not carry this load alone due to constrained resources; our readers are encouraged to post relevant comments in the section below and they will be used in the preparation of the CRE analyses which will be forwared to the FDA. (Detailed studies can be posted in the Concepts and Studies Discussion Forum)

Leading public health experts and campaigners are urging the US Food and Drug Administration (FDA) to ban menthol cigarettes from sale in the United States, and say a clutch of papers published in the American Journal of Public Health this week provide a strong case for doing so.

One paper describes a study that ran computer models and estimated that if a ban were to be introduced now, it could prevent more than 600,000 premature American deaths by 2050, a third of them among African Americans.

Another paper reports a survey that found a ban on menthol cigarette sales would have the support of more than half of the American population, including three quarters of African Americans (four out of every five African American smokers smoke menthol cigarettes).

And a third paper reports a study that shows people who smoke menthol cigarettes find it harder to quit.

The studies follow a recent study from the National Cancer Institute that found 39% of all menthol smokers, including nearly half of all African American menthol smokers, said they would quit smoking altogether rather than switch to another type of cigarette, if the US were to ban menthol cigarettes.

In March this year, the FDA’s Tobacco Products Scientific Advisory Committee (TPSAC) concluded that banning menthol cigarettes, which account for 30% of US cigarette sales, would benefit public health. Menthol cigarettes are the only flavored cigarette not banned in the US. The FDA is considering their conclusions and is due to make a decision sometime in June.

The American Academy of Pediatrics, American Public Health Association, the think tank Center for American Progress and the tobacco-rejection campaign organization Legacy, are among the groups calling for the FDA to accept their panel’s recommendations and ban menthol cigarettes.

Dr David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at Legacy, was senior author on all three papers, and also on a fourth that discusses tobacco regulation and policy integration. He told the press that:

“With the momentum of this new research and public support for a ban on menthol, now is the time for the FDA to finally act on this important issue.”

“Tobacco is not an equal-opportunity killer, and the link between menthol smoking and African Americans cannot be overemphasized, nor can it be overlooked,” he urged.

Dr. Georges Benjamin, Executive Director of the American Public Health Association (APHA), said:

“The consensus of responsible scientists now strongly confirms that menthol flavorings lure youth to start smoking and then make it harder for menthol smokers to quit.”

Aisha Moodie-Mills, Advisor for LGBT Policy & Racial Justice at the Center for American Progress said:

“Menthol-flavoring is a gateway into a lifetime of smoking and smoking-related diseases, especially for African American and gay and transgender youth who smoke menthol cigarettes at the highest rates.”

One of the co-authors of the paper that discusses tobacco regulation and policy, Dr Cheryl G. Healton, president and CEO of Legacy, said “the evidence backing a menthol ban is sound science and consistent with the language in the Family Smoking Prevention and Tobacco Control Act”.

“Modeling the Future Effects of a Menthol Ban on Smoking Prevalence and Smoking-Attributable Deaths in the United States.”
David Levy, Jennifer Pearson, Andrea Villanti, Kenneth Blackman, Donna Vallone, Raymond Niaura, and David Abrams.
DOI:10.2105/AJPH.2011.300179. Found here

“Quit Attempts and Quit Rates Among Menthol and Nonmenthol Smokers in the United States.”
David Levy, Kenneth Blackman, John Tauras, Frank Chaloupka, Andrea Villanti, Raymond Niaura, Donna Vallone, and David Abrams.
DOI:10.2105/AJPH.2011.300178. Found here

Seems like some of these statistics peddle by the quotes are being culled from thin air, which is disconcerting, given the repute of some of these organizations.

In regards to the US Attitudes about banning menthol in cigarettes – the methods are somewhat flawed and like someone pointed out – the questions biased.

About menthols and youth – African Americans start smoking at older ages, compared to other Americans. Someone needs to find out, what crucial event is occurring between in African American adulthood that turns previous abstainers to smoke cigarettes. I think the answer will lie in more societal forces and not individual preferences for a particular cigarette.

Also, the fact that only the majority of menthol smokers , if facing a ban, will turn to regular cigarettes presents another problem. It promotes the erroneous message that non-mentholated cigarettes, consumed by non-Blacks, are inherently safer than menthols – which is not true when you look at longterm outcomes – like lung cancer rates and even short-term outcomes like biomarker load. Also, given the nature of public health. Non-mentholated cigarettes will now become the next “healthy cigarette.” Health outcomes between mentholated and non-mentholated African American smokers are largely similar – however, differences in health outcomes between white and black smokers are stark.